MEDICARE: RACHEL MARIA PISTON APRN-CNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	118256	OK
2	363LF0000X	Family Nurse Practitioner	118256	OK
3	363LF0000X	Family Nurse Practitioner	223892	AR

General Provider Information

NPI Number	:	1134780034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RACHEL MARIA PISTON APRN-CNP

Provider Business Mailing Address
First Line	:	PO BOX 776084
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-6084
Country	:	US
Telephone Number	:	314-543-6979
Fax Number	:	314-364-6321

Provider Business Practice Location Address
First Line	:	4600 MERCY LN
Second Line	:
City	:	SPRINGDALE
State	:	AR
Zip	:	72762-3070
Country	:	US
Telephone Number	:	479-338-4400
Fax Number	:	479-338-3808

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/22/2019
Last Update Date	:	01/21/2025

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